If only I had known that

Garry ChapmanUncategorized


If only I had known that

Wouldn’t it be nice if more ‘old hands’ in private practice were inclined to share their tips for success with the next generation?
Fortunately, an eagle-eyed Garry Chapman – tongue firmly in cheek – unearthed this letter to a new independent practitioner from a kindly newly retired specialist

20 February 2014

The Old Consultant Practice
Consulting Rooms
Any Private Hospital

Dear New Consultant,
I know that we have not met, but I have been told that you will be taking over my consultation rooms now that I have retired.
This has made me think back to when I started in private practice – which seems a lifetime ago. I thought about ‘things I wish I had known’ when starting way back then.
So it is with this in mind that I write to you in the hope that, should you take only one piece of my advice, it will make your private practice life so much smoother than mine was in the early years.
The first thing you should be aware of (if you are not already) is that you will have been used to sharing medical knowledge with your colleagues throughout your career.
But when it comes to the commercial aspects of running a private practice, you will find the majority of your colleagues, for obvious reasons, will be shy about sharing information.
The most common mistake new consultants make is not to recognise that, once they enter private practice, they are now running a business with all the associated costs that are involved with that.
In the first instance, it would be prudent to set up a business bank account in order to keep your finances separate from any domestic ones. I certainly wish I had contacted an accountant before I had started out in private practice to get expert advice on the best way to structure my practice from a business and tax perspective.
This would have saved me an awful lot of stress in dealing with the taxman as well as saving me thousands of pounds in tax fees. This is especially true today when taking into account the myriad of ways that a business can be structured and the associated complex tax rules.
Another key area is to make sure that your practice wife – your secretary – is one that matches your personality. You are likely to spend considerable time with her, so it makes sense that you should both get along with each other.
A mistake I made in the early years was to persevere with a secretary where we clearly had different ideas on how things should function on a day-to-day basis. Ultimately, this affects the practice, so make sure that you spend the necessary time in finding the right secretary to work with. It will be time well spent.
Remember, your private practice has running costs, so it is vital to make sure that this crucial area is dealt with correctly and that you collect what you have billed. This was my biggest area of weakness and, for many years, I lost thousands of pounds a year! It was a painful experience and I regret it even more so now that I am retired.
The assumption I made at the beginning was that this was a simple thing to do and that everyone would pay me for my time and expertise. Looking back, I cannot believe how naive I was.
The first thing I got wrong was that I billed my codes at incorrect prices. I made an assumption that all insurance companies paid the same fee. How wrong I was. I found out much later that the prices for the CCSD codes could differ by 100% depending upon the specific code.
On top of this, I later found out that there are rules regarding which codes can be billed together which can also be different for each insurance company. This lack of knowledge also cost me thousands of pounds.
I also found out – way too late – that there were quite a large percentage of my patients that were not paying me for my services. At the time, I could not understand why they did not want to pay.
As I had come into private practice to focus on the medical side, I did not want to have to discuss finances with my patients. Back then, I thought it was poor business practice to be chasing them for money. This attitude cost me a lot of restless nights and huge tax bills on money that I had invoiced but never collected.
The answer to my problems regarding the medical billing and collection was when I was introduced to a company that specialised in this field. It took on my backlog of unpaid invoices and was very successful in collecting these.
It billed my procedures at the correct rate for each insurance company and kept my bad debts down to less than half of one per cent on all my billings. On top of this, it dealt with all the queries from both the insurance companies and patients. This enabled me and my secretary to focus on the patient.
My practice was transformed and my only regret was that I had not been told about them sooner, as it would have saved me a lot of money and enabled me to sleep at nights without worrying about the bills that had to be paid.
You have spent a major part of your life becoming the expert in your specialty. Other people have spent a similar amount of time becoming an expert in their field, so if you only take one piece of advice from this letter, it would be to employ experts in their respective fields. This leaves you to focus on what you do best, which is the medical side.
I wish you all the best for the future and hope your journey in private practice is as enjoyable as mine was. But without the bumps along the way.

Yours sincerely,

A Retired Consultant

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